Clinico-pathological features of breast carcinoma in elderly Egyptian patients: A comparison with the non-elderly using population-based data

AbstractBackgroundBreast cancer (BC) is a major worldwide health care problem that mostly afflicts the elderly population in the more developed countries. It is not known how common is breast cancer among elderly Egyptian patients and whether this differs from the disease in younger patients.AimsTo study the clinico-pathological features of BC in elderly Egyptian patients (⩾65years of age) among the population of an Egyptian Governorate, Gharbiah, and to compare these features with those of younger patients (<65years).MethodsThis is a cross sectional study that compares elderly BC (EBC) and the non-elderly BC (NEBC) using the information from the Gharbiah Population-based Cancer registry (GPCR) during the years 1999–2007.ResultsOut of 6078 BCs, 12% were EBCs and 88% were NEBCs. Between 1999 and 2007, the crude incidence rate (CIR, per 100,000 populations) of EBC increased from 47 to 71 and that of NEBC increased from 16 to 17. Compared to NEBC patients, EBC patients were more likely to have a positive family history and present with a distant disease and less likely to present with a localized disease. EBCs were more likely to have lung metastases and less likely to have liver metastases. Histology, grade, hormone and HER-2 receptor statuses were comparable in both groups. Apart from hormonal therapies, the elderly were less likely to receive surgery, radiotherapy or chemotherapy.ConclusionEBC patients in Egypt present with advanced disease and are less likely to receive surgery, radiotherapy or chemotherapy compared to NEBC patients

The utilization of sodium lignosulphonate extracted from Egyptian rice straw in leather tanning process

Massive quantities of rice straw are burned annually in Egypt and caused environmental hazards. The present study investigated the utilization of rice straw to produce sodium lignosulphonate (SLS) as a water-soluble derivative of lignin in leather tanning and evaluate its usage as a tanning or re-tanning material as well as its effect on leather quality. The results of testing SLS as a leather tanning agent were unsatisfactory due to its slight effect on shrinkage temperature of leathers, unlike its use as a re-tanning material. Four concentrations of SLS (0%, 5%, 10%, and 20%) were used in re-tanning forty of sheep wet-blues. The results showed that using SLS as a re-tanning agent with concentration till 10% from pelts weight enhances some organoleptic properties, such as fullness and general appearance together with slight improvement in physical properties of leathers. Moreover, the addition of SLS with concentration 20% led to an excessive swelling in the collagen fibers as shown from depicted scanning electron micrographs and decreased trends of physical properties

Evaluation of Digital Brixmeter Performance for Brix Measurement In Raw Sugar Solution

The Brix value is an important factor in the sugar industry's extraction processes. Brix refers to the amount of sucrose in the raw sugar solution. The concentration of dissolved solids in a solution is measured by the degree Brix (symbol °Bx). One gram of sucrose in 100 grams of solution equals one-degree Brix. a New Suggested method for measuring brix was designed to be low-cost and accurate Brix measuring in raw sugar solutions. it was depended on Electronic sensors can directly measure the mass, and temperature of the solution to express the brix and give the result on the screen. Digital suggested brixmeter was made based on this method. It can be used manually on the production line and in various food industries. The aim of this paper was to evaluate the digital brixmeter performance for measuring brix in raw sugar solutions. Brix measurements were tested for a group of samples at different sizes to find the optimal measurement sizes can verify accurate brix degree value. The factors affecting the accuracy of the measurement were also studied. The results were compared with the brix read from accurate optical refractometer to check and a prove the accuracy of the proposed digital brixmeter

Assessment of patient safety culture perception among healthcare workers in intensive care units of Alexandria Main University Hospital, Egypt

Background: Patient safety culture (PSC) is a vital feature to assess the ability of any healthcare setting in addressing and reducing patients harm. This study attempted to assess the PSC in Intensive Care Units (ICUs) at Alexandria Main University Hospital (AMUH) from the point of view of physicians and nurses. Methods: A cross-sectional study was implemented in two ICUs at AMUH over period of six months. Seventy-two participants were interviewed using the Hospital Patient Safety Scale, customized by the Agency for Healthcare Research and Quality (AHRQ). Results: The average positive response to individual items in the patient safety scale ranged from 2.7% to 79.2%. The “Teamwork within Units” dimension had the utmost average percentage positive score (63.5%) amongst all participants, on the other hand, the “Non-Punitive Response to Errors” dimension had the lowest one (12.0%). Less than half (45.8%) of the interviewed participants rated patient’s safety at the hospital as accepted. Conclusions: PSC is friable in targeted ICUs, much of work is needed to raise the responsiveness of health care givers regarding this issue. Executives and supervisors need to encourage the practices of PS through a blame free culture

The utilization of sodium lignosulphonate extracted from Egyptian rice straw in leather tanning process

Massive quantities of rice straw are burned annually in Egypt and caused environmental hazards. The present study investigated the utilization of rice straw to produce sodium lignosulphonate (SLS) as a water-soluble derivative of lignin in leather tanning and evaluate its usage as a tanning or re-tanning material as well as its effect on leather quality. The results of testing SLS as a leather tanning agent were unsatisfactory due to its slight effect on shrinkage temperature of leathers, unlike its use as a re-tanning material. Four concentrations of SLS (0%, 5%, 10%, and 20%) were used in re-tanning forty of sheep wet-blues. The results showed that using SLS as a re-tanning agent with concentration till 10% from pelts weight enhances some organoleptic properties, such as fullness and general appearance together with slight improvement in physical properties of leathers. Moreover, the addition of SLS with concentration 20% led to an excessive swelling in the collagen fibers as shown from depicted scanning electron micrographs and decreased trends of physical properties

Effect of aerobic exercise, slow deep breathing and mindfulness meditation on cortisol and glucose levels in women with type 2 diabetes mellitus: a randomized controlled trial.

Background: Aerobic exercise combined with breathing exercise can be an integral part of diabetes mellitus treatment. This single-center, randomized, parallel-group study investigated the effect of the combination of aerobic exercise with slow deep breathing and mindfulness meditation on the glucose and cortisol levels of women with type 2 diabetes mellitus (T2DM). Materials and Methods: Fifty-eight middle-aged women with T2DM (mean age: 45.67 ± 2.92 years) were randomly assigned to either the aerobic training group (AT: n = 29; mean age [46.1 ± 2.7 years]) or the aerobic exercise combined with slow deep breathing and mindfulness meditation (AT + DMM: n = 29; mean age [45.24 ± 3.14 years]). Aerobic exercise was performed at 60%-75% of the maximum heart rate. The women in each group were asked to perform the training three times weekly over a 6-week period. The duration of each session was 40 min for the AT group and 60 min for the AT + DMM group. The two groups were asked to perform aerobic exercise at 60%-75% of the maximum heart rate. Their fasting blood glucose (FBG) and serum cortisol levels were measured at the baseline and after the 6 weeks. Results: Compared with the AT group, the group undertaking 6 weeks of aerobic training combined with slow, deep breathing exercises and mindfulness meditation showed significantly lower levels of FBG (p = 0.001) and cortisol levels (p = 0.01) than the AT group. Conclusion: The addition of slow deep breathing and mindfulness meditation to aerobic exercise can better control the glucose and cortisol levels of women with T2DM and thereby improve their outcomes and decrease their cardiometabolic risk

Effect of aerobic exercise, slow deep breathing and mindfulness meditation on cortisol and glucose levels in women with type 2 diabetes mellitus: a randomized controlled trial

Background: Aerobic exercise combined with breathing exercise can be an integral part of diabetes mellitus treatment. This single-center, randomized, parallel-group study investigated the effect of the combination of aerobic exercise with slow deep breathing and mindfulness meditation on the glucose and cortisol levels of women with type 2 diabetes mellitus (T2DM). Materials and Methods: Fifty-eight middle-aged women with T2DM (mean age: 45.67 ± 2.92 years) were randomly assigned to either the aerobic training group (AT: n = 29; mean age [46.1 ± 2.7 years]) or the aerobic exercise combined with slow deep breathing and mindfulness meditation (AT + DMM: n = 29; mean age [45.24 ± 3.14 years]). Aerobic exercise was performed at 60%–75% of the maximum heart rate. The women in each group were asked to perform the training three times weekly over a 6-week period. The duration of each session was 40 min for the AT group and 60 min for the AT + DMM group. The two groups were asked to perform aerobic exercise at 60%–75% of the maximum heart rate. Their fasting blood glucose (FBG) and serum cortisol levels were measured at the baseline and after the 6 weeks. Results: Compared with the AT group, the group undertaking 6 weeks of aerobic training combined with slow, deep breathing exercises and mindfulness meditation showed significantly lower levels of FBG (p = 0.001) and cortisol levels (p = 0.01) than the AT group. Conclusion: The addition of slow deep breathing and mindfulness meditation to aerobic exercise can better control the glucose and cortisol levels of women with T2DM and thereby improve their outcomes and decrease their cardiometabolic risk

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p&lt;0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p&lt;0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec

Frequency Stability of AC/DC Interconnected Power Systems with Wind Energy Using Arithmetic Optimization Algorithm-Based Fuzzy-PID Controller

This article proposes an intelligent control strategy to enhance the frequency dynamic performance of interconnected multi-source power systems composing of thermal, hydro, and gas power plants and the high penetration level of wind energy. The proposed control strategy is based on a combination of fuzzy logic control with a proportional-integral-derivative (PID) controller to overcome the PID limitations during abnormal conditions. Moreover, a newly adopted optimization technique namely Arithmetic optimization algorithm (AOA) is proposed to fine-tune the proposed fuzzy-PID controller to overcome the disadvantages of conventional and heuristic optimization techniques (i.e., long time in estimating controller parameters-slow convergence curves). Furthermore, the effect of the high voltage direct current link is taken into account in the studied interconnected power system to eliminate the AC transmission disadvantages (i.e., frequent tripping during oscillations in large power systems–high level of fault current). The dynamic performance analysis confirms the superiority of the proposed fuzzy-PID controller based on the AOA compared to the fuzzy-PID controller based on a hybrid local unimodal sampling and teaching learning-based optimization (TLBO) in terms of minimum objective function value and overshoots and undershoots oscillation measurement. Also, the AOA’s proficiency has been verified over several other powerful optimization techniques; differential evolution, TLBO using the PID controller. Moreover, the simulation results ensure the effectiveness and robustness of the proposed fuzzy-PID controller using the AOA in achieving better performance under several contingencies; different load variations, the high penetration level of the wind power, and system uncertainties compared to other literature controllers adjusting by various optimization techniques